KEVIN R HADDLE DDS MD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

HADDLE

Suffix

DDS MD

Business Name

KEVIN R HADDLE DDS MD

Original Issue Date

06/12/2003

Effective Date

09/28/2015

Expiration Date

09/30/2018

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018